In response to growing demand, the number of daycare facilities in Missouri is increasing each year. So are the problems.

Even for facilities that are licensed and inspected, breaking the rules usually means little more than a slap on the wrist. Inspectors are likely to give violators a second chance and, in some cases, a third, fourth, fifth or sixth chance. The most common penalty for a serious violation, such as forgetting a child on a field trip, involves a "facility review conference," in which the child-care provider meets with state officials, signs off on a perfunctory corrective-action plan and agrees to follow the rules, train employees or develop a plan to prevent a recurrence of the problem.

At the KinderCare on Cross Keys Drive in Florissant, where children were left in a van for 80 minutes, an inspector concluded that four state regulations had been broken. The driver was fired; the area manager contacted the parents of the children involved, and other van drivers were "advised to follow KinderCare policies regarding transportation of children." The state concluded that those actions "resolve the issue."

At the Children's Corner in Webster Groves, where the 3-year-old was imprisoned with plywood over a playpen, the owner was told to consult with the state before implementing any "unusual" techniques. She was asked to develop a "special needs" plan for children with special needs. The state agreed to make extra visits over a 90-day period. The facility kept its license, and in April, the state allowed Children's Corner to increase the number of children the center cared for, from eight to 10, provided the owner hired another caregiver.

Corinne Patton, coordinator of the public-awareness campaign for the Missouri Child Care Resource and Referral Network: "There is a lot going on in child care right now; we are getting more attention than ever before. Some of that close scrutiny is going to point out what is not OK."

Jennifer Silverberg

Corinne Patton, coordinator of the public-awareness campaign for the Missouri Child Care Resource and Referral Network: "There is a lot going on in child care right now; we are getting more attention than ever before. Some of that close scrutiny is going to point out what is not OK."

At the La Petite Academy on De Paul Drive in Bridgeton, which was the subject of a series of substantiated complaints, the state held a facility-review conference in May 1998 after repeated instances in which the center violated staff-to-children ratios. La Petite agreed to abide by the ratios and log the number of children and staff present every 15 minutes for a two-week period while undergoing unannounced inspections. In March 1999, a worker gave an infant unauthorized medication for gas because he was "bawling his head off." That worker was fired. Two months later, a worker was seen pulling 2-year-olds from a fence and throwing them to the ground. Four months after that, in September, a 3- year-old fell off a slide, but his mother wasn't called until four-and-a-half hours later -- during which time the boy's elbow swelled. At the emergency room that evening, the mother learned that her son had a broken elbow. The state's response was to require a staff meeting explaining "parental notification" rules when a child is injured and have employees sign a form agreeing to abide by the rules.

Franklin, the state's bureau chief of child care, says inspectors repeatedly try to work with a facility to correct its problems. "We try to be very fair and very consistent," she says. "We hate for children to be left behind on field trips. When they fire that employee who is responsible, do we close that center and put 60 families out without care? If they have taken action to prevent it from happening again, and they talk to the person and fire them, in many instances, hopefully it won't repeat itself. Each case is so unique."

Sometimes the problems repeat themselves anyway. A lack of supervision was repeatedly found at the Tendercare Learning Center in Florissant in 1998 and 1999. At one point, as many as 14 3- and 4- year-olds were taken on a field trip with a single staff person, violating state-mandated ratios. A 6-year-old climbed atop the facility's roof, unnoticed by staff; a neighbor called to alert them. A 7-year-old walked home from the center unnoticed. And a 9-year-old was sent out to clean a daycare van in the parking lot, unsupervised. At a facility-review conference in December, Tendercare agreed not to let children leave the building unsupervised or leave them unattended and to train staff on those procedures.

Only the most alarming violations carry any risk of closure. Franklin says the most severe sanctions -- suspension or revocation of licensure -- are generally reserved for facilities where "something drastic happened to a child" or the violations "continue and continue and continue."

Of more than 4,000 licensed facilities statewide, and hundreds where violations were substantiated, just two dozen were subjected to the state's most serious sanctions in 1999 -- fewer than 1 percent. Fifteen signed a "settlement agreement," two had their initial licenses denied, three had their license renewals denied and four licenses were revoked. Another seven were referred to prosecutors for providing child care without a license.

Those whose licenses were revoked included Mary Marleen Beard of Lake Ozark, who is charged with second-degree murder in the alleged shaking death of Elijah Steen, who died last October of brain injuries while at Beard's family child-care home. Lisa Butler of Kansas City, a family child-care home provider, had her license revoked in November after she was caught -- seven times -- allowing animals to roam freely in the children's outdoor play area, including a goat, two dogs and two cats. She had been forbidden from doing so in May 1998 after one of her dogs bit a 17-month-old child in the face, requiring six stitches. The state also revoked the license of Christine Lawson, who ran a St. Joseph home with a long list of unresolved safety problems, after a 2-year-old wandered off unnoticed in October 1998. He was found a half-mile away.